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Riller Q, Cohen-Aubart F, Roos-Weil D. [Splenic lymphoma, diagnosis and treatment]. Rev Med Interne 2022; 43:608-616. [PMID: 35691756 DOI: 10.1016/j.revmed.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022]
Abstract
Some common clinical situations, such as splenomegaly or lymphocytosis, or less common, such as autoimmune hemolytic anemia, cold agglutinin disease, or cryoglobulinemia can lead to the diagnosis of splenic lymphoma. Splenic lymphoma is rare, mainly of non-hodgkinian origin, encompassing very different hematological entities in their clinical and biological presentation from an aggressive form such as hepato-splenic lymphoma to indolent B-cell lymphoma not requiring treatment such as marginal zone lymphoma, the most frequent form of splenic lymphoma. These entities can be challenging to diagnose and differentiate. This review presents different clinical and biological manifestations suspicious of splenic lymphoma and proposes a diagnosis work-up. We extended the strict definition of splenic lymphoma (lymphoma exclusively involving the spleen) to lymphoma thant can be revealed by a splenomegaly and we discuss the differential diagnosis of splenomegaly.
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Affiliation(s)
- Q Riller
- Service de médecine interne 2, Centre national de référence maladies systémiques rares, hôpital Pitié-Salpêtrière, Sorbonne université, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
| | - F Cohen-Aubart
- Service de médecine interne 2, Centre national de référence maladies systémiques rares, hôpital Pitié-Salpêtrière, Sorbonne université, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - D Roos-Weil
- Service d'hématologie clinique, hôpital Pitié-Salpêtrière, Sorbonne université, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
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GÜNER B, ORHAN B, ERSAL T, OZKOCAMAN V, ALİ R, ÖZKALEMKAŞ F. Marginal zone lymphoma presenting in a patient with autoimmune hemolytic anemia: a case report. TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.904114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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3
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Wang D, Shao S, Zhang Y, Zhao D, Wang M. Insight Into Polysaccharides From Panax ginseng C. A. Meyer in Improving Intestinal Inflammation: Modulating Intestinal Microbiota and Autophagy. Front Immunol 2021; 12:683911. [PMID: 34354704 PMCID: PMC8329555 DOI: 10.3389/fimmu.2021.683911] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 12/17/2022] Open
Abstract
Polysaccharides from Panax ginseng C. A. Meyer (P. ginseng) are the main active component of P. ginseng and exhibit significant intestinal anti-inflammatory activity. However, the therapeutic mechanism of the ginseng polysaccharide is unclear, and this hinders the application for medicine or functional food. In this study, a polysaccharide was isolated from P. ginseng (GP). The primary structure and morphology of the GP were studied by HPLC, FT-IR spectroscopy, and scanning electron microscopy (SEM). Further, its intestinal anti-inflammatory activity and its mechanism of function were evaluated in experimental systems using DSS-induced rats, fecal microbiota transplantation (FMT), and LPS-stimulated HT-29 cells. Results showed that GP modulated the structure of gut microbiota and restored mTOR-dependent autophagic dysfunction. Consequently, active autophagy suppressed inflammation through the inhibition of NF-κB, oxidative stress, and the release of cytokines. Therefore, our research provides a rationale for future investigations into the relationship between microbiota and autophagy and revealed the therapeutic potential of GP for inflammatory bowel disease.
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Affiliation(s)
- Dandan Wang
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.,Jilin Provincial Key Laboratory of BioMacromolecules of Chinese Medicine, Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Shuai Shao
- College of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Yanqiu Zhang
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Daqing Zhao
- Jilin Provincial Key Laboratory of BioMacromolecules of Chinese Medicine, Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.,Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Mingxing Wang
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.,Jilin Provincial Key Laboratory of BioMacromolecules of Chinese Medicine, Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China
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Splenic marginal zone lymphoma associated with hepatitis B virus infection, remission after viral treatment, and splenectomy: A case report and review of the literature. Hematol Oncol Stem Cell Ther 2019; 14:153-155. [PMID: 31306619 DOI: 10.1016/j.hemonc.2019.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/30/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022] Open
Abstract
We report the case of a patient diagnosed with a splenic marginal zone lymphoma with a simultaneous finding of hepatitis B virus infection, who responded to antiviral treatment and splenectomy. We highlighted this association described in the literature and its possible causal role, as well as the available therapeutic choices.
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Mohamed S. [Splenic marginal zone lymphoma]. Pan Afr Med J 2017; 26:111. [PMID: 28533834 PMCID: PMC5429422 DOI: 10.11604/pamj.2017.26.111.11446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/18/2017] [Indexed: 12/02/2022] Open
Abstract
Le lymphome à cellules de la zone marginale splénique (LZMS) est un lymphome B exceptionnel, bien définie dans la classification OMS 2016 des tumeurs hématopoïétiques, qui peut être source de pièges diagnostiques. Patiente âgée de 72 ans, hospitalisait pour l’exploration d’une énorme splénomégalie confirmée par une tomodensitométrie (TDM). Le bilan biologique était normal. Une splénectomie a été réalisée. L’étude microscopique de la pièce opératoire montrait une prolifération lymphomateuse diffuse à petites cellules, avec un marquage par le CD20. Le CD 5 et le CD 43 sont négatifs. Le diagnostic d’un LZMS a été retenu. Le LZMS est représente moins de 2% de l’ensemble lymphomes non hodgkiniens. Il touche le sujet âgé de plus de 50 ans, caractérisé habituellement par la présence d'une splénomégalie volumineuse sans adénopathies. L'hémogramme montre dans trois quarts des cas la présence inconstante de lymphocytes villeux. Le diagnostic est essentiellement anatomopathologique, il montre une atteinte constante nodulaire ou parfois diffuse de la pulpe blanche du parenchyme splénique. Les cellules tumorales sont de petite taille exprimant les marqueurs lymphoïdes B: CD19, CD20, CD22, CD79. Elles sont négatives pour le CD5, CD10, la cyclinde D1 et le CD43. Aucune anomalie cytogénétique spécifique du LZMS n'a été identifiée. C’est un lymphome indolent dont le traitement est jusqu’à ce jour non codifié, dépend des facteurs pronostiques. Le décès est lié au risque de transformation à un lymphome à grandes cellules.
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Affiliation(s)
- Sinaa Mohamed
- Service d'Anatomie Pathologique, Hôpital Militaire Moulay Ismail, Meknès, Maroc
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Hofheinz K, Schett G, Manger B. Adult onset Still’s disease associated with malignancy—Cause or coincidence? Semin Arthritis Rheum 2016; 45:621-6. [DOI: 10.1016/j.semarthrit.2015.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/07/2015] [Accepted: 10/07/2015] [Indexed: 01/11/2023]
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Colafrancesco S, Priori R, Valesini G. Presentation and diagnosis of adult-onset Still’s disease: the implications of current and emerging markers in overcoming the diagnostic challenge. Expert Rev Clin Immunol 2015; 11:749-61. [DOI: 10.1586/1744666x.2015.1037287] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Interference from lupus anticoagulant on von Willebrand factor measurement in splenic marginal zone lymphoma: a case report. Blood Coagul Fibrinolysis 2014; 26:454-7. [PMID: 25485787 DOI: 10.1097/mbc.0000000000000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We present a case concerning a patient with splenic marginal zone lymphoma (SMZL) and isolated prolonged activated partial thromboplastin time (aPTT) caused by lupus anticoagulant. Von Willebrand factor (VWF) activity and antigen were immeasurable by latex particle immunoturbidimetric assays, and several coagulation factor levels were decreased. However, VWF activity and antigen were normal when analyzed by other methods. Also, coagulation factor levels were normal if an aPTT reagent with low lupus anticoagulant sensitivity or a chromogenic method was applied. Altogether, the initial findings were because of lupus anticoagulant interference and in fact, the patient had normal VWF activity and coagulation status. Interference of lupus anticoagulant in clot-based assays is well known but has not previously been described in VWF assays. This is furthermore the first report in which lupus anticoagulant activity in SMZL cannot be ascribed to a monoclonal immunoglobulin. In our study, aPTT normalized after treatment, suggesting resolution of lupus anticoagulant. APTT could thus be a marker of treatment response in SMZL. Whether treatment decreases the thrombosis risk due to lupus anticoagulant remains unknown.
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Pseudomaladie de Still et néoplasie : une observation de mélanome et revue de la littérature. Rev Med Interne 2014; 35:60-4. [DOI: 10.1016/j.revmed.2013.02.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 02/11/2013] [Indexed: 11/19/2022]
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Liu L, Wang H, Chen Y, Rustveld L, Liu G, Du XL. Splenic marginal zone lymphoma: a population-based study on the 2001–2008 incidence and survival in the United States. Leuk Lymphoma 2012; 54:1380-6. [DOI: 10.3109/10428194.2012.743655] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Lihua Liu
- Institute of Hospital Management, Chinese People's Liberation Army General Hospital,
Beijing, P. R. China
| | - Haijun Wang
- Quality and Clinical Systems Integration, Texas Children's Hospital,
Houston, TX, USA
| | - Yiming Chen
- Department of Lymphoma/Myeloma, The University of Texas M. D. Anderson Cancer Center,
Houston, TX, USA
| | - Luis Rustveld
- Department of Family and Community Medicine, Baylor College of Medicine,
Houston, TX, USA
| | - Gengxin Liu
- Lanfang Health Vocational College,
Langfang City, P. R. China 065001
| | - Xianglin L. Du
- School of Public Health, Division of Epidemiology, University of Texas Health Science Center at Houston,
Houston, TX, USA
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Lechner K, Simonitsch I, Haselböck J, Jäger U, Pabinger I. Acquired immune-mediated thrombophilia in lymphoproliferative disorders. Leuk Lymphoma 2011; 52:1836-43. [DOI: 10.3109/10428194.2011.580474] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Grabska J, Dasanu CA. Autoimmune phenomena in untreated and treated marginal zone lymphoma. Expert Opin Pharmacother 2011; 12:2369-79. [PMID: 21679092 DOI: 10.1517/14656566.2011.591381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Current literature suggests an association between various autoimmune conditions and marginal zone lymphoma (MZL). However, these autoimmune conditions have not been comprehensively systematized to date. As a result, their clinical implications remain largely unknown. AREAS COVERED The authors provide a comprehensive review of the existing literature on various autoimmune abnormalities documented in the course of MZL, as well as on autoimmune alterations induced by certain MZL therapies. EXPERT OPINION The course of MZL is accompanied by a variety of hematologic and non-hematologic autoimmune disorders. Whereas some of them could be secondary and related to the course of the MZL, others may be primary and might even favor the development of MZL itself. In addition, authentic autoimmune conditions have been documented with the use of rituximab as a single agent and the nucleoside analogs. Therefore, we believe caution should be exerted with the use of these agents in MZL patients with evidence of autoimmune disorders, as exacerbation of autoimmune phenomena can be anticipated. While the heterogeneity of the MZL subtypes represents an inherent limitation, integration of emerging information from immunology research laboratories and clinical practice could translate into improved outcomes of this disease spectrum.
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Affiliation(s)
- Joanna Grabska
- University of Connecticut Medical Center, Department of Internal Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
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